Menopause & the comeback for HRT

Dr Nadia Oozeerally, a GP with a specialist interest in women’s health at Your Private GP Service, Ashtead Hospital, has been a dedicated advocate for Hormone Replacement Therapy (HRT) for over 20 years. She recently completed the Certificate in menopause by the British menopause Society and ensure she is up to date with the HRT treatments for women. In this article, she explores how HRT can support women’s mental health, vitality, and sexual wellbeing throughout the perimenopause and beyond.

Understanding Menopause and Hormonal Decline

From puberty, the ovaries produce the majority of the body’s oestrogen. This continues until later in life when ovarian function declines, eventually ceasing altogether. As oestrogen levels fluctuate and diminish, many women experience significant physical and emotional symptoms, including irregular or heavy periods—a phase known as the perimenopause.

Menopause is officially diagnosed when a woman has had no menstrual bleeding for 12 consecutive months. The average age of menopause in the UK is 51, though symptoms can begin years before and persist for many years afterward.

Common Perimenopausal Symptoms Include:

• Hot flushes
• Mood swings
• Irregular or heavy bleeding
• Brain fog
• Low libido
• Restless legs

These symptoms stem from the body’s adjustment to the loss of oestrogen it has relied upon for decades.

The Role and Benefits of HRT

Modern HRT typically involves oestrogen in the form of oestradiol gel or skin patches, both of which closely mimic the natural oestrogen produced by the ovaries. These transdermal options are now preferred due to their safety and effectiveness.

Oestrogen offers a wide range of benefits:

• Protection against cardiovascular disease
• Preservation of bone density, reducing the risk of osteoporosis
• Support for cognitive function, potentially delaying the onset of dementia
• Improved skin elasticity and hair growth
• Enhanced overall quality of life

Additionally, the ovaries produce testosterone, which plays a key role in maintaining libido. In many cases, testosterone is included as part of the HRT regimen for women experiencing a decline in sexual desire.

For women with a uterus, progesterone is also required to prevent the oestrogen-induced thickening of the uterine lining. Progesterone can be delivered via tablet, patch, or ideally through an intrauterine system such as the Mirena coil.

The Evolution of HRT

Since its introduction in 1942, HRT has undergone a dramatic journey. Initially hailed as a breakthrough treatment, its reputation suffered in the 1990s following reports linking it to an increased risk of breast cancer and cardiovascular issues. However, subsequent research has clarified these risks, and the benefits of HRT—when appropriately prescribed—are now well-supported by scientific evidence. As a result, demand for HRT is once again on the rise.

Today, HRT can be tailored to each woman’s needs, with various delivery methods including gels, patches, oral tablets, vaginal preparations, and intrauterine devices. Transdermal options are often preferred as they bypass the gastrointestinal system, avoiding the metabolic by-products that can cause side effects with oral HRT.

A Tailored and Safe Approach at Your Private GP Service

At Your Private GP Service, we are committed to providing a personalised, safe, and evidence-based approach to HRT. Every woman’s hormonal needs are different, and we take time to assess each individual thoroughly. This includes performing relevant blood tests to check baseline hormone levels, assess general health, and identify any underlying conditions that may affect treatment.

Once HRT is initiated, we continue to monitor patients closely through follow-up consultations and periodic blood testing. This active monitoring allows us to adjust dosages as needed, ensure hormone levels remain balanced, and check for any potential side effects or complications. Our goal is to ensure optimum safety, effectiveness, and long-term health for every patient on HRT.

By combining oestrogen, testosterone, and progesterone (if required), women can transition through menopause with greater ease, maintaining their energy, wellbeing, and confidence. HRT is safe for long-term use, and many women choose to remain on treatment because of the significant improvement in their quality of life.

Book your HRT appointment today on 01372 221 400

Our GPs are in clinic every weekday, offering face to face and telephone consultations, longer appointments can be booked on request.